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Unjustified use of hormone therapy high among elderly women with breast cancer
Wink CJ. Ann Surg Oncol. 2011;doi:10.1245/s10434-011-2070-z.
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The increased use of hormone treatment among the oldest women with operable breast cancer requires more research given that a recent study found the treatment is inferior to primary surgical treatment among this group, as well as a lack of evidence supporting its use as a primary therapy in this population.
Researchers from the Netherlands conducted a study to evaluate the trend of increased use of hormone treatment in women aged 75 years or older with operable breast cancer. Data were gathered from the Eindhoven Cancer Registry on all women aged 75 years or older who were diagnosed with breast cancer from 1988 to 2008.
During the study period from 1988 to 2008, 4,650 patients in the Netherlands were diagnosed with breast cancer, 23% of whom were treated with primary endocrine therapy. Overall trends indicated that, although there was a decline in endocrine therapy between 1997 to 2000, the use of endocrine therapy increased to 29% during the latest study period from 2005 to 2008.
The mean age of women treated with endocrine therapy in this population was 85 years. Of those women treated with endocrine therapy, 58% had an initial response, 12% achieved stable disease and 35% eventually showed progression.
The 5-year survival of those women receiving endocrine therapy was 27% (95% CI, 19.1-34.8) compared with 62.3% (95% CI, 59.4-65.2) for those women who received primary surgical treatment.
Reasons given for use of primary endocrine treatment instead of surgery were numerous and included the presence of comorbidities and age alone.
“The definite role of primary endocrine therapy in the management of breast cancer in the elderly needs to be further addressed,” the researchers wrote. “There is still a lack of evidence to justify the current widespread use of PET as a primary therapy for elderly women with breast cancer.”
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